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Paeds Casesprofessional-practice-and-evidence

Paeds Cases · professional-practice-and-evidence

Supporting a fatigued colleague after a near miss — OSCE

OSCE on supporting a fatigued trainee who is the second victim of an intercepted tenfold opioid near miss, with attention to immediate patient safety, second-victim support, the demands-resources mechanism, and a systems response.

osce clinician wellbeing and second-victim support3 min readVerification in progress

Target exams

MRCPCH ClinicalRACP DCERCPSC Pediatrics
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Study tools

Target exams

MRCPCH ClinicalRACP DCERCPSC Pediatrics
Prompt
On a night shift a paediatric registrar near the end of a long shift almost gives a tenfold opioid dose to a young child; the nurse intercepts it; the child is unharmed; the registrar is exhausted, tearful and says she feels she is bad at her job; the candidate (the consultant on the phone and then in person) must ensure patient safety, support the trainee as a second victim, and describe the system change.

Station brief (8–10 minutes)

A registrar on a night shift almost gave a tenfold opioid dose to a young child. The nurse intercepted it and the child is unharmed. You are the consultant. The registrar is exhausted — she has slept poorly for weeks — tearful, and says she feels she is "bad at her job." Confirm patient safety, support the trainee, and describe the system response that would make this service sustainable. Do not invent local statutory wording or practitioner-health contact names you do not know. [1] [3]

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References4ShowHide
  1. [1]Landrigan CP Effect of reducing interns' work hours on serious medical errors in intensive care units N Engl J Med, 2004.PMID 15509817
  2. [2]West CP Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis Lancet, 2016.PMID 27692469
  3. [3]Wu AW Medical error: the second victim. The doctor who makes the mistake needs help too BMJ, 2000.PMID 10720336
  4. [4]Scott SD The natural history of recovery for the healthcare provider second victim after adverse patient events Qual Saf Health Care, 2009.PMID 19812092
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